• 한국산학기술학회논문지
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• 제11권6호
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• pp.2161-2168
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• 2010

본 연구는 행정자료인 건강보험 및 의료급여비용 청구자료를 이용하였으며, 일개지역(2개도, 남 북)에 개설 되어있는 전체 의료기관을 대상으로 진료일 기준 '08.7월~'08.12월(184일)동안 외래 방문이 1회 이상인 30세 이상의 수진자 485,953명을 대상으로 하였다. 진료지속성과 영향 요인을 분석한 결과 다음과 같다. 우리나라 성인 고혈압 환자의 평균 진료지속성 수준은 MMCI, $0.96{\pm}0.13$, MFPC $0.96{\pm}0.12$으로 높게 나타났다. 외래진료 지속성에 영향을 미치는 요인으로는 여성일수록, 55세~64세 이상 연령일수록, 동반상병이 있을수록 통계적으로 유의하게 낮았으며, 주이용기관이 상위 종별일수록 통계적으로 유의하게 MMCI와 MFPC 모두 높게 나타났다. 이 연구에서는 우리나라 성인 고혈압환자의 평균 진료지속성 수준은 높은 것으로 나타났으며, 여성, 64세 이상 연령 등 진료지속성이 낮은 대상자에 대한 관리가 필요할 것으로 보인다. 이 연구 결과는 우리나라 고혈압환자들의 건강관리 행태를 모니터하는 지표 및 국가의 고혈압관리사업의 성과지표로써 활용할 수 있을 것이다.

• 임상간호연구
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• 제19권1호
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• pp.115-127
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• 2013

Purpose: This study aimed to describe how nurses in neurological intensive care units (ICU) perceive their roles about patient transfer and liaison. Methods: A cross-sectional survey was conducted using a questionnaire developed for the study. Data were collected from a convenience sample of 115 nurses working in the neurological intensive care units ofsix university hospitals. Data were analyzed using SPSS software (version 15.0). Results: Staff nurses were mainly in charge of patient transfer, and the awareness about its importance was significantly related with the burden about the practice of patient transfer (p<.001). Patient liaison was mainly conducted by staff nurses as well. Liaison practice wassuggested to be started from the ICU at the time of transfer; the suggested time for completion of liaison service and evaluation was when patients were adjusted to the transferred ward. Preparing job descriptions and increasing nursing staffing for patient liasion service were strongly recommended. Conclusion: The results suggest that the ICU nurses' burden in relation to patient transfer is commensurate with their awareness about itsimportance. To improve the continuity of care from ICU to transferred ward, it isrequired to reduce the burden about patient transfer and improve perceptions about patient liaison.

• 가정간호학회지
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• 제27권2호
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• pp.198-209
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• 2020

Purpose: This study sought to develop a scale to evaluate patient-centered healthcare services at hospitals and verify its reliability and validity. Methods: We conducted a literature review and interviewed medical personnel and practitioners in medical institutions. We also conducted a content validation and preliminary survey of experts, including 40 preliminary items. We conducted the main survey among 240 medical institution workers to assess the validity and reliability of the preliminary measurement tool. Results: The validity and reliability of the scale were assessed by 29 items underlying six factors: ease of communication, continuity and extension of the hospital's role, stable environment, emotional support, respect for patients' values, and offer of information. Cronbach's α of the whole tool was .91, while the value of each factor ranged from .82 to .74, thereby verifying its reliability. Conclusion: The patient-centered healthcare services scale was identified as a tool appropriate for healthcare professionals. This tool will be useful in a diverse range of research on the development of educational programs for patient-centered healthcare services and the promotion of patient-centered causes.

• 대한전자공학회:학술대회논문집
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• 대한전자공학회 2009년도 정보 및 제어 심포지움 논문집
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• pp.402-404
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• 2009

The development of health information technology enables people to access, view and acquire personal health record. But still, there have been a number of obstacles such as the absence of the standard to realize the ideal Personal Health Record(PHR) system. In this study, we proposed the service model that serves periodic Health Record Summary which is made by a medical specialist to people who are in the busy lives. Healthcare data from EMR in a hospital including people generate themselves at home is sent to a physician to make a medical opinion, and then it is changed into Health Level 7 Continuity of Care Document(CCD) format for interoperability. After a physician writes his opinion about patient's health condition, it will send to people by email. People who receive the health record summary data by email can save them into a USB device to view own PHR and medical comments of a physician through a computer. It will help people managing their own health condition with an opinion of a medical specialist.

• 여성건강간호학회지
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• 제2권1호
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• pp.25-39
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• 1996

The Korean government has a new system for charging patient care for patients in hospital, on hold for the present(9 / 1995) but to start implementation in certain areas of patient care next year. From the latter half of next year the Ministry of Health and Welfare would like to start demonstration projects for hospitals who want to start using DRGs for frequently seen medical diagnosis and for patients with a course that is predictable and for whom non-insurance costs are minimal : such as the patient who has a delivery, cesarean deliveries, cataract surgery, tonsillectomy or an appendectomy, and apply the DRG system of payment for hospital care for these patients. The purpose of this study was to establish a recording system to give effective home health care to postpartum women and their newborns. Recently the government announced a DRG system to apply to postpartum women for pilot purposes starting next year. This gives impetus to the need to develop home care records that will allow for systematic recording and provide continuity and consistency in care across all health professionals and with in-depth communication between the professions to assure high quality care. There has been a rise in medical costs and a shortage of patient bed space in hospitals, particularly since the introduction of national medical insurance. The study focused on developing client selection criteria, a primary assessment tool, progress notes and nursing diagnoses applicable to postpartum and newborn clients. Selection criteria for home health care, assessment tool content, nurses progress notes and diagnoses were developed through a review of the literature, advice from professionals who are expert in home health care and actual practice in the use of recording tools through workshops. The recommendations based on the research results are as follows : 1) Replication and application of these tools is needed to test the validity of the tools 2) In order to have systematic nursing records standardization of records has to be done after nurses have had experience using them. 3) Reliability and validity of the tools has to be established through applicability to actual care situation.

• 보건의료산업학회지
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• 제12권1호
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• pp.81-93
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• 2018

Objectives : This cross-sectional study aims to investigate the differences in general health status (GHS) and physical care burdens (PCB) of inpatient groups in long-term care hospitals (LTCH). Methods : The data of 228 patients were analyzed by integrating the electronic medical record (EMR) data of 2016, recorded by the nurses of hospitalized patients in the hospital. Results : There was a statistically significant difference in the GHS between the high-medical demand group and the other groups, but there was no difference in the GHS among other groups. The overall PCB was higher in the high-medical demand group than in the middle-medical demand, and cognitive impairment groups, but not in the problem behavioral group. Conclusions : The current classification of patient groups has shown limitations in terms of the basis of differential benefits of the groups. In particular, the PCB of the problem behavior group was not different from that of any group; hence, it should be adjusted through further study. To control the surge of medical care costs, it is necessary to improve the irrationality of the LTCH pay system in terms of the integration and continuity for elderly care.

• 한국의료질향상학회지
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• 제25권2호
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• pp.26-43
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• 2019

Purpose:The objective of this study was to identify the conceptual constructs of patient centeredness from the perspective of patients and family members in Korea, and to compare them with those included in the Picker Institute framework. Methods: Two focus group discussions were conducted. Each focus group consisted of six participants who had experienced being either a patient or a caregiver. We carried out a thematic analysis, and then compared the contents of our focus group discussions with the components of patient-centered care outlined by the Picker Institute. Results: Six conceptual constructs of patient centeredness emerged from the focus group discussions. Five of these overlapped with those outlined by the Picker Institute: 1)respect for patients' values, preferences, and needs, 2) coordination and integration of care, 3) information, communication, and education, 4) physical comfort, and 5) emotional support and alleviation for fear and anxiety. A new component that was not mentioned in the Picker Institute framework emerged from this study: "ease of making a complaint." Currently, "involvement of family and friends" and "continuity and transition" were not prominent components of patient centeredness according to our focus group discussions. Conclusions: This study presents the conceptual constructs of patient centeredness, five of which overlap with those outlined by the Picker Institute, and provides a qualitative basis of the patient experience survey currently being implemented by the Health Insurance Review & Assessment Service in Korea.

• 문화기술의 융합
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• 제8권6호
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• pp.135-140
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• 2022

우리는 본 연구에서 현재 우리나라 치유농장에서 시범적으로 운영되고 있는 치유농업 프로그램을 시행하고 이를 경험한 치매 대상자의 환자보호자로서의 경험과 느낌을 인터뷰하고 치유농업 프로그램의 장점 및 단점을 확인 하였다. 이에 우리는 치유농장 프로그램 및 운영에 있어서 개선점과 프로그램의 특징 등에 대해서 알아 보았다. 특히, 치매 초기 단계의 치유농장 이용, 거주지에서 치유농장으로 이동하는 접근성문제, 다양한 프로그램과 프로그램의 연속성, 그리고 계절에 맞는 콘텐츠 개발에 의견을 모으고 있다. 앞으로의 치유농장에서 치유농업을 활용하여 치매환자에게 치유농업 관련 프로그램을 개발하기 위해 초기 치매 환자의 이용문제, 접근성, 다양성, 연속성, 계절성 등의 요소를 고려해야 할 것으로 보여진다.

• 한국의료질향상학회지
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• 제22권1호
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• pp.11-26
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• 2016

The Organization for Economic Cooperation and Development, which has continuously evaluated the performance of healthcare systems, has recently invested much effort into hospital performance measurement. The purpose of this paper is to introduce the hospital performance measurement programs operated by international organizations or at the national level based on the OECD's hospital performance project. Health Insurance Review & Assessment service (HIRA)'s quality assessment was analyzed based on the analytical framework of the OECD's hospital performance project. The hospital performance measurement programs of WHO, Canada, Australia, United States and United Kingdom are briefly explored, in view of the conceptual framework, key performance dimensions and indicators that are currently in use. The OECD suggested seven key dimensions of hospital performance: timeliness, efficiency, continuity, effectiveness and appropriateness, staff orientation, patient orientation and safety. The analysis of the quality assessment program of HIRA, which operates 36 diseases and procedures and 347 indicators, shows that the numbers of indicators are relatively small in the areas of safety, patient centeredness and efficiency. Continuity of care and staff orientation are not fully developed also, but the situations are similar in other countries. In conclusion, hospital performance measurement using stable and comprehensive data should be developed to improve overall system performance, and discussions on a conceptual framework that can lay out directions and key performance domains need to take into place.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제22권1호
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• pp.28-40
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• 2019

The incidence of pediatric-onset inflammatory bowel disease (IBD) is on the rise, accounting for up to 25% of IBD cases. Pediatric IBD often has extensive bowel involvement with aggressive and rapidly progressing behavior compared to adult IBD. Because IBD has a high morbidity rate and can have a lifelong impact, successful transition from pediatric to adult care is important to maintain the continuity of care. Furthermore, successful transition facilitates appropriate development and psychosocial well-being among patients, as well as comprehensive and harmonious healthcare delivery amongst stakeholders. However, there are various obstacles related to patients, family, providers, and organizations that interfere with successful transition. Successful transition requires a flexible and tailored plan that is made according to the patient's developmental abilities and situation. This plan should be established through periodic interviews with the patient and family and through close collaboration with other care providers. Through a stepwise approach to the transition process, patients' knowledge and self-management skills can be improved. After preparation for the transition is completed and the obstacles are overcome, patients can be gradually moved to adult care. Finally, successful transition can increase patients' adherence to therapy, maintain the appropriate health status, improve patients' self-management, and promote self-reliance among patients.